Active NPI
Corina Suzanne Gonzalez, OTR
- Occupational Therapist
- Mission, TX
National Provider Identifier
1538336227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 112253
- Practice address
- 2521 E Interstate Highway 2 Ste 600
Mission, TX 78572-9811 - Phone
- (956) 997-6100
- Fax
- (956) 229-6185
- NPI assigned
- May 12, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 112253 | TX | Primary |
Addresses
Primary practice location
2521 E Interstate Highway 2 Ste 600
Mission, TX 78572-9811
Mailing address
367 S Gulph Rd
King of Prussia, PA 19406-3121
Phone (956) 997-6100
Other practice location 1
228 E Mile 3 Rd Ste 190B
Mission, TX 78573-0156
Phone (956) 997-6565
Other practice location 2
6400 N 10th St
Suite C
McAllen, TX 78504-3385
Phone (956) 451-8853
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 193320203 | Medicaid | TX | |
| 1O2237 | Other | TX | PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 112253 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Core Therapeutics, LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Rehabilitation Clinic/Center
- McAllen, TX
- NPI 1659676120
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620604800000",
"number": "1538336227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "367 S GULPH RD",
"city": "KING OF PRUSSIA",
"state": "PA",
"postal_code": "194063121",
"telephone_number": "956-997-6100",
"fax_number": "956-229-6185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2521 E INTERSTATE HIGHWAY 2 STE 600",
"city": "MISSION",
"state": "TX",
"postal_code": "785729811",
"telephone_number": "956-997-6100",
"fax_number": "956-229-6185"
}
],
"practiceLocations": [
{
"address_1": "228 E Mile 3 Rd Ste 190B",
"address_purpose": "LOCATION",
"city": "Mission",
"state": "TX",
"postal_code": "785730156",
"country_code": "US",
"telephone_number": "956-997-6565",
"fax_number": "956-229-6188",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6400 N 10th St",
"address_2": "Suite C",
"address_purpose": "LOCATION",
"city": "McAllen",
"state": "TX",
"postal_code": "785043385",
"country_code": "US",
"telephone_number": "956-451-8853",
"fax_number": "956-687-9102",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GONZALEZ",
"first_name": "CORINA",
"middle_name": "SUZANNE",
"name_prefix": "Mrs.",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-12",
"last_updated": "2021-05-10",
"certification_date": "2021-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "112253",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "193320203",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN",
"identifier": "1O2237",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mission, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.